n International SportMed Journal - Lower back pain in cyclists : a review of epidemiology, pathomechanics and risk factors : review article

Volume 11, Issue 1
  • ISSN : 1528-3356



Lower back pain (LBP) appears to be a common overuse injury in cycling. However, there are few scientific studies that report on the epidemiology and risk factors associated with LBP in cyclists. The prolonged flexed posture that a cyclist maintains may lead to increased mechanical strain of the lumbar spine, causing LBP. In this article, the epidemiology, pathomechanics and risk factors associated with LBP in cyclists will be critically reviewed.

An extensive literature review was conducted using an evidence-based approach. Using selective keywords (lower back pain, cyclists, bicycle set-up, risk factors) a search was undertaken on the PubMed database to identify all research publications that relate to lower back pain in cyclists.
Although epidemiological studies were limited, LBP was shown to be a common cycling overuse injury. The point prevalence of LBP in cyclists ranged from 10-60%. It has been suggested that LBP in cyclists may be prevented by adjusting certain bicycle parameters to match the anthropometric measurements of the cyclist. Pathomechanical hypotheses for the development of LBP in cyclists are poorly supported, and most studies were conducted over time periods shorter than one hour. Monitoring cyclists over a longer period of cycling may yield more accurate data. There is strong evidence supporting the incorrect saddle angle as an intrinsic risk factor is associated with LBP in cyclists.
In conclusion, additional research on the epidemiology of LBP in cyclists is necessary. Further research studies, such as case control and intervention studies are necessary to study pathomechanics and risk factors associated with LBP in cyclists.

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